Medicaid

Federal Health Policy Update for April 10

The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House and Senate were in recess this week and are scheduled to be back in session on April 14. House Speaker Mike Johnson (R-LA) has indicated that the House will not vote on the Senate‑passed Department of Homeland Security continuing resolution until there is meaningful progress on a reconciliation package to fund U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection. In an effort to narrow the scope [...]

joe2026-04-10T13:43:20-04:00April 10, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|

Search for Undocumented Medicaid Participants Not Yielding Major Results

An administration effort to identify undocumented U.S. residents illegally enrolled in Medicaid is not turning up many undocumented residents illegally enrolled in Medicaid. At least not so far. Last fall, the administration sent the names of hundreds of thousands of suspected illegal Medicaid participants to the states and directed them to review the eligibility of those individuals. Data from five states, however, has not turned up many such individuals. Between them, Colorado and Pennsylvania reviewed 79,000 names and found none illegally enrolled in their state Medicaid programs. Texas reviewed 28,000 records and terminated 77 people from the program. Ohio checked [...]

joe2026-04-07T16:53:00-04:00April 9, 2026|Medicaid|

States Looking to Swap Medicaid Taxes

With Medicaid provider taxes on the road to oblivion as a result of passage of last year’s H.R. 1, often referred to as “The One Big Beautiful Act Law,” a number of states are looking to Medicaid managed care plan taxes to replace at least some of the tax revenue they will lose from the demise of Medicaid provider taxes. Iowa has already adopted such a tax, more than tripling its Medicaid managed care plan tax in the middle of its fiscal year. The state even increased taxes on managed care plans that do not serve Medicaid patients. Elsewhere, lawmakers [...]

joe2026-04-07T14:42:09-04:00April 8, 2026|Medicaid|

Federal Health Policy Update for April 3

The following is the latest health policy news from the federal government for March 27 to April 3. Some of the language used below is taken directly from government documents. Proposed and Final CMS Medicare Regulations Proposed FY 2027 Medicare Inpatient Rehabilitation Facilities Payment Rule CMS has published a proposed rule updating Medicare payment policies and rates for inpatient rehabilitation facilities (IRF) under its IRF prospective payment system and updating the IRF quality reporting program for FY 2027. CMS proposes updating FY 2027 IRF rates by 2.4 percent based on a market basket update of 3.2 percent less a proposed [...]

joe2026-04-03T13:22:10-04:00April 3, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for March 26

The following is the latest health policy news from the federal government for March 20-26. Some of the language used below is taken directly from government documents. Congress Republican leadership is exploring a reconciliation bill as a potential vehicle to fund Immigrations and Customs Enforcement (ICE) and pass the Safeguard American Voter Eligibility Act (SAVE) voting rights act. If pursued, this approach could increase the likelihood of additional health care cuts, including expanding site-neutral payment policies in both Medicare and Medicaid. It is not clear whether there will be sufficient support in either chamber for Republicans to pursue a party-line [...]

joe2026-03-26T15:09:34-04:00March 26, 2026|Alternative payment models, Center for Medicare and Medicaid Innovation, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for March 19

The following is the latest health policy news from the federal government for March 13-19. Some of the language used below is taken directly from government documents. The White House President Trump has issued an executive order creating a Task Force to Eliminate Fraud that “…shall, on behalf of the President, coordinate and accelerate a comprehensive national strategy to stop fraud, waste, and abuse within Federal benefit programs, including programs administered jointly with State, local, tribal, and territorial partners.” The vice president will chair the task force, the Secretary of the Department of Health and Human Services is among its [...]

joe2026-03-19T15:41:48-04:00March 19, 2026|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

MACPAC Submits March Report to Congress

The Medicaid and CHIP Payment and Access Commission has submitted its mandated March report to Congress. The report consists of four chapters: Chapter 1 offers a recommendation to support the home- and community-based services (HCBS) workforce by requiring states to report hourly wages paid to HCBS workers to help states set effective HCBS payment rates. Chapter 2 focuses on behavioral health in Medicaid and CHIP. Chapter 3 looks at the role of Medicaid in supporting justice-involved youth. Chapter 4 provides an overview of how Medicaid meets the needs of children in child welfare. Learn more from this MACPAC news release, which summarizes the [...]

joe2026-03-17T13:15:26-04:00March 18, 2026|MACPAC, Medicaid, Medicaid long-term services and supports|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. The following is MACPAC’s own summary of its two days of public meetings. MACPAC’s March meeting began with a discussion on the role of automation in the Medicaid prior authorization (PA) process. MACPAC conducted a literature review, a federal policy review, and stakeholder interviews on the role of automation in the PA process. During this session, we reviewed findings and challenges that surfaced in this research, including the extent to which automation is already in use in Medicaid PA; the availability of information and documentation [...]

joe2026-03-12T15:08:27-04:00March 16, 2026|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care|

Federal Health Policy Update for March 12

The following is the latest health policy news from the federal government for March 6-12. Some of the language used below is taken directly from government documents. Congress While the House was in recess this week, the Republican caucus held its annual retreat to discuss legislative priorities. Speaker Mike Johnson (R-LA) continues to push for another reconciliation bill, hoping to revisit several proposals to reduce Medicaid spending that were not included in HR another rank-and-file Republicans have expressed doubt that this will be possible. Both chambers of Congress are scheduled to be in session next week. The House Committee on [...]

joe2026-03-12T16:09:44-04:00March 12, 2026|Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare post-acute care, Medicare reimbursement policy|

CMS Lays Out Medicaid Eligibility Redeterminations

More than eight months after passage of HR 1, the “One Big Beautiful Bill Act,” the Centers for Medicare & Medicaid Services has provided formal guidance to the states on how to redetermine Medicaid eligibility for certain Medicaid beneficiaries – a major part of the bill’s health care changes. Under that law, states must redetermine affected individuals’ continued Medicaid eligibility every six months beginning with renewals scheduled on or after January 1, 2027. CMS is giving states two options for redetermining Medicaid eligibility. They may: move an individual’s previously set 2027 renewal date to an earlier date in 2027 to space out [...]

joe2026-03-11T08:08:31-04:00March 11, 2026|Medicaid|